Peng Hong-Yan, Zhu Yi-Min, Zhang Xin-Ping, Kang Xia-Yan
Emergency Center, Hunan Children's Hospital, Nanhua University, Changsha 410007, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2015 Nov;17(11):1183-8.
To evaluate the value of pancreatic stone protein/regenerating protein (PSP/reg) in severity evaluation and prognosis prediction for children with sepsis.
In this prospective case-control study, 159 children with sepsis (106 cases in the sepsis group; 53 cases in the severe sepsis group, including 12 cases of septic shock) and 20 children without sepsis (control group) were enrolled. ELISA was applied to measure plasma PSP/reg levels on days 1, 3, and 7 of admission to the PICU. The Spearman rank correlation test was applied to assess the correlations between plasma PSP/reg level and serum procalcitonin (PCT), CRP, WBC count, and pediatric critical illness score (PCIS). The area under the receiver operating characteristic curve (AUC) was used to assess the value of each index in determining severity and predicting prognosis for children with sepsis.
On day 1 of admission to the PICU, plasma PSP/reg levels in the sepsis and severe sepsis groups were significantly higher than in the control group (P<0.05), and the severe sepsis group had a significantly higher plasma PSP/reg level than the sepsis group (P<0.05). On day 1 of admission to the PICU, the survival group (n=132) had a significantly lower plasma PSP/reg level than the non-survival group (n=27) (P<0.05). On day 1 of admission to the PICU, plasma PSP/reg level in children with sepsis was positively correlated with WBC count and serum PCT level (rs=0.212 and 0.548, respectively; both P<0.05), and negatively correlated with PCIS score (rs=-0.373; P<0.05). The AUCs of plasma PSP/reg level and serum PCT for determination of severe sepsis, septic shock, and death were higher than 0.7 (P<0.05).
PSP/reg is closely related to infection, and has a certain clinical value in risk stratification of sepsis and prognosis evaluation.
评估胰石蛋白/再生蛋白（PSP/reg）在儿童脓毒症严重程度评估及预后预测中的价值。
在这项前瞻性病例对照研究中，纳入了159例脓毒症患儿（脓毒症组106例；严重脓毒症组53例，包括12例感染性休克）和20例无脓毒症患儿（对照组）。采用酶联免疫吸附测定法（ELISA）在入住儿科重症监护病房（PICU）的第1天、第3天和第7天测量血浆PSP/reg水平。采用Spearman等级相关检验评估血浆PSP/reg水平与血清降钙素原（PCT）、C反应蛋白（CRP）、白细胞计数（WBC）及小儿危重病例评分（PCIS）之间的相关性。采用受试者工作特征曲线（ROC）下面积（AUC）评估各指标在判断儿童脓毒症严重程度及预测预后中的价值。
入住PICU第1天，脓毒症组和严重脓毒症组的血浆PSP/reg水平显著高于对照组（P<0.05），且严重脓毒症组的血浆PSP/reg水平显著高于脓毒症组（P<0.05）。入住PICU第1天，存活组（n=132）的血浆PSP/reg水平显著低于非存活组（n=27）（P<0.05）。入住PICU第1天，脓毒症患儿的血浆PSP/reg水平与WBC计数及血清PCT水平呈正相关（rs分别为0.212和0.548，均P<0.05），与PCIS评分呈负相关（rs=-0.373；P<0.05）。血浆PSP/reg水平及血清PCT用于判断严重脓毒症、感染性休克及死亡的AUC均高于0.7（P<0.05）。
PSP/reg与感染密切相关，在脓毒症风险分层及预后评估中具有一定的临床价值。
